TAG:
revenue cycle management
Behind the Cat-and-Mouse Game of Lab Reimbursement
Financial relationships between clinical laboratories and commercial payers have evolved into a high-stakes, technological tug-of-war. For nearly a decade, the clinical laboratory industry has wrestled with the provisions of the Protecting Acce…
Report Identifies Practices of Top RCM Performers
Revenue cycle management (RCM) can be a headache for all healthcare providers, including clinical laboratories and anatomic pathology practices. However, some organizations handle the challenges better than others. This was the key takeaway fro…
Payers Unleash AI to Dissect Outlier Billing Patterns
Diagnostic laboratories can follow every clinical guideline, employ the most talented clinical lab professionals, and provide life-saving data to patients, yet still find themselves in the crosshairs of a federal or payer audit. The culprit is …
Why Labs Must Rethink Audit Readiness in 2026
CEO SUMMARY: Doing everything right is no longer enough to ensure claims are paid. With AI-driven audits on the rise, lab leaders must ensure their organizations can prove compliance—quickly, clearly, and consistently. Based on commentary from RCM experts Ann Lambrix and…
Providers May Be Ordering Inappropriate Vitamin D Tests
Heightened consumer interest has been driving demand for vitamin D testing in recent years. However, clinical laboratories should be aware that some providers could be ordering the wrong test to measure levels of the vitamin, in part due to the way that online or…
Revenue Concerns to Watch at Home and Abroad
This issue of The Dark Report explores…
RCM Automation Helps Lab Manage Billing Headaches
CEO SUMMARY: In an era where it is widely suspected that private payers are using artificial intelligence to review and deny diagnostic test claims, Southwest Labs in New Mexico decided to fight back. The organization worked with RCM firm Wuscott to figure out why claims w…
AI Reshapes Job Market: New Priorities for Clinical Labs
Artificial intelligence (AI) is no longer a future consideration in the job market. Instead, it is actively reshaping how professionals find work, how roles are defined, and which skills employers value most. According to recent LinkedIn resear…
Clinical Labs Battle Complex Claims Denials
CEO SUMMARY: While the number of denials is not going up, the reasons that private payers deny claims are becoming more complex and time-consuming to appeal. After reviewing noteworthy trends among payers, learn a three-level approach to appeals that may lead to greater su…
Don’t Let the Payers Enjoy All the Benefits of Data
PROBABLY SINCE THE ADVENT OF M…
CURRENT ISSUE
Volume XXXIII, No. 11 – September 2026
In the September 2026 briefing, The Dark Report digs into a CMS proposal to cut payments for CPT code 88305, potentially based on flawed thinking. Other coverage includes the evolving role of mass spectrometry in clinical labs, payer obstacles to blood-based biomarker tests for Alzheimer’s disease, and how young pathologists can get business skill help.
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